Delayed graft function in renal transplantation : aetiology and impact on graft outcome
The optimal therapy for most patients with end stage renal disease is renal transplantation. This form of therapy results in improved quality of life, decreased medical expense, and perhaps a survival advantage for the recipient. Renal transplantation is however a complex form of therapy which may be associated with signiﬁcant complications. The most common allograft complication post transplantation is the development of delayed graft function with a reported incidence of between 23 to 34%. This is a costly complication requiring ongoing dialysis and prolonged hospitalization. It also has a signiﬁcant emotional impact on the patient and their family. Of greater concern though are the reports in the literature which associate delayed graft function with decreased graft survival. With current organ shortages organ donor criteria have been expanded to match the shortage. It is thus imperative that we should understand the mechanisms of graft damage which may result in delayed graft function. A better understanding of the relationship between delayed graft function and graft survival might signiﬁcantly impact on our practice in certain settings such as in the use of organs harvested from a marginal donor.
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